<h2>Payment Information</h2>

<div class="steps_box">
    <ol>
        <li class="step_passed">1. Guest Details</li>
        <li class="step_current">2. Payment Information</li>
        <li class="step_next">3. Confirm Details</li>
        <li class="step_next">4. Complete Booking</li>
    </ol>
</div>

<?php
if($GLOBALS['note']){
	echo display_message($GLOBALS['note']);
}
$values_form = $_SESSION['booking']['payment'];
$billing_counties = array(
    'Antrim',
    'Armagh',
    'Carlow',
    'Cavan',
    'Clare',
    'Cork',
    'Derry',
    'Donegal',
    'Down',
    'Dublin',
    'Fermanagh',
    'Galway',
    'Kerry',
    'Kildare',
    'Kilkenny',
    'Laois',
    'Leitrim',
    'Limerick',
    'Longford',
    'Louth',
    'Mayo',
    'Meath',
    'Monaghan',
    'Offaly',
    'Roscommon',
    'Sligo',
    'Tipperary',
    'Tyrone',
    'Waterford',
    'Westmeath',
    'Wexford',
    'Wicklow',
);
$billing_country_codes = array(
    'IE' => 'Republic of Ireland',
    'NI' => 'Northen Ireland',
);
?>

<h4 class="title_brd_yellow">Payment Details</h4>
<form action="booking_payment.php" method="post" />
    <input type="hidden" name="action" value="validate" />      
<table class="aqua">
    <tr>
        <td width="150">Card Holder Name <span class="form_required_ast">*</span></td>
        <td><input type="text" name="cc_holder_name" value="<?= $values_form['cc_holder_name'] ?>" class="buy_gv_input" /></td>
    </tr>
    <tr>
        <td width="150">Card Type <span class="form_required_ast">*</span></td>
        <td>
            <select name="cc_type" class="buy_gv_input">
                <option value="">Please Select</option>
                <option value=""></option>
                <option value="VISA" <?= selected("VISA",$values_form['cc_type']) ?>>Visa</option>
                <option value="MC" <?= selected("MC",$values_form['cc_type']) ?>>Mastercard</option>
                <option value="LASER" <?= selected("LASER",$values_form['cc_type']) ?>>Laser</option>
            </select>
    </tr>
    <tr>
        <td>Card Number <span class="form_required_ast">*</span></td>
        <td><input type="text" name="cc_number" value="" class="buy_gv_input" /></td>
    </tr>
    <tr>
        <td>Security Code <span class="form_required_ast">*</span></td>
        <td><input type="text" name="cc_security_code" value="" class="buy_gv_input_cvn" maxlength="3" /> </td>
    </tr>
    <tr>
        <td>Expiry Date <span class="form_required_ast">*</span></td>
        <td>
<select name="card_expiry_month" class="">
<option value=""></option>
<?
for($i=1;$i<=12;$i++){
$j=$i;
if($j<10)$j = "0".$j;
?>
<option value="<?= $j ?>" <?= selected($j,$values_form['card_expiry_month']) ?>><?= $j ?></option>
<? } ?>
</select>
-
<select name="card_expiry_year" class="">
<option value=""></option>
<?
for($i=date('y');$i<date('y')+9;$i++){
$j=$i;
//if($j<10)$j = "0".$j;
?>
<option value="<?= $j ?>" <?= selected($j,$values_form['card_expiry_year']) ?>><?= $j ?></option>
<? } ?>
</select></td>
    </tr>
    <tr>
        <td>Name on Card <span class="form_required_ast">*</span></td>
        <td><input type="text" name="card_name" value="<?= $values_form['card_name'] ?>" class="buy_gv_input" /></td>
    </tr>
    
    <tr><td colspan="2">Your address must be the address associated with the above card for payment.</td></tr>
     <tr>
        <td width="150">Address <span class="form_required_ast">*</span></td>
        <td><input type="text" name="cc_address1" value="<?= $values_form['cc_address1'] ?>" class="buy_gv_input" /></td>
    </tr>
    <tr>
        <td>Town <span class="form_required_ast">*</span></td>
        <td><input type="text" name="cc_city" value="<?= $values_form['cc_city'] ?>" class="buy_gv_input" /></td>
    </tr>
    <tr>
        <td>County <span class="form_required_ast">*</span></td>
        <td>
            <select name="billing_county">
                <option value="">Please Select</option>
                <option></option>
                <?php foreach ($billing_counties as $county): ?>
                <option value="<?=$county?>" <?=$county==$values_form['billing_county']?'selected="selected"':''?>><?=$county?></option>
                <?php endforeach; ?>
            </select>
        </td>
    </tr>
    <tr>
        <td>Country <span class="form_required_ast">*</span></td>
        <td>
            <select name="cc_country_code" class="buy_gv_input">
                <option value="">Please Select</option>    
                <option value=""></option>
                <?php foreach ($billing_country_codes as $code=>$title): ?>
                <option value="<?=$code?>" <?=$code==$values_form['cc_country_code']?'selected="selected"':''?>><?=$title?></option>
                <?php endforeach; ?>
            </select>
        </td>
    </tr>
    
    
</table>
<br />

<span id="siteseal"><script type="text/javascript" src="https://seal.godaddy.com/getSeal?sealID=wlMkbEUkdgIL5ios1K9dNCcE7UcFGqWo04GX6vPx6Vi5N9D762J"></script></span>



<input type="submit" value="submit" alt="Next" />

</form>


